Grant: Operating Grant

Acute kidney injury (AKI) represents a sudden decline in kidney function and is associated with a high risk of death. When AKI is severe, some patients require the initiation of kidney replacement therapy in the form of dialysis. Dialysis replaces the kidneys' usual functions by the removal of toxins, minerals and excess fluid from the blood. There is substantial debate about when to start dialysis in patients with AKI. The standard approach is to wait until a life-threatening complication of AKI develops. However, some small studies suggested that starting therapy sooner may be of benefit. We propose an international multicentre randomized controlled trial to establish whether early/accelerated dialysis initiation, versus standard initiation, in patients with AKI leads to improved survival. We will also examine whether early/accelerated dialysis initiation leads to differences in the rates of kidney recovery, non-kidney organ failure and costs to the healthcare system.